Masood Raza Khan, Aruna Dawani, Taseer Ahmed Mumtaz, Masoom Raza Mirza, Saleem Khan, Zakiuddin G Oonwala.
Total extra-peritoneal laparoscopic inguinal hernia repair: an experience at a teaching hospital.
Pak J Surg Jan ;29(2):134-8.

Objective: To determine the outcome of patients who underwent total extra-peritoneal repair for groin (inguinal) hernias. Design: Retrospective descriptive study. Setting: This study was carried out at Hamdard University Hospital and other private hospitals of Karachi form July 2009 to July 2011. Methodology: A total of 47 patients underwent total extra-peritoneal repair under general anaesthesia during this period, 4 of these patients had bilateral inguinal hernia, therefore a total of 51 TEP surgeries were performed. A 15x15cm polypropylene(Ethicon) mesh was used in all cases. Th e majority of the patients were discharged within 24hrs and follow up was done at 1 week, 1 month and 1 year. Operative morbidity, post operative pain, seroma formation, evidence of superfi cial infection, chronic groin pain and hernia recurrence was noted. Results: 51 hernias were required in 47 patients over the period of two years. Mean age of petients was 34.7 years (range 18 - 75 years). None of the precedure were converted to open inguinal hernia repair. Post operative pain was observed in 14.89% of the cases and was easily controlled by oral analgesics. Five patients developed seroma, out of which one required aspiration while others settled conservatively. None of the patients developed wound infection, scrotal hematoma or, neuralgia. Return to activity after TEP repair was found to be a median of 16.1 days. No recurrennces were noticed till one year of follow up. Conclusion: Total extra-peritoneal procedure for inguinal hernia repair using proline mesh is a safe and effective procedure with low morbidity, early return to normal activity and no recurrence after one year follow up.

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